PSY 245 CLINICAL PSYCHOLOGY

1. PSY 245CLINICAL PSYCHOLOGY • Assoc. Prof. Dr. BAHAR BAŞTUĞ • Clinical Psychologist

2. Individual Psychology & Adlerian Therapy

3. Alfred Adler (1870 – 1937), founder of individual psychology

4. Welcome • Today we’ll be focusing on individual psychology which is a theory and therapy approach developed by Alfred Adler. • This approach is typically referred to as Adlerian therapy. • Although some people still refer to Adler as one of Freud’s students, he was Freud’s contemporary and developed his own, very different, approach to counseling and psychotherapy.

5. He’s like a man from the future. • Some labels Adler as a neo-Freudian.??? • Adler’s Individual Psychology is a psychoeducational, present/future oriented, and brief approach. • Adler’s psychology was far ahead of its time. He’s known as the father of CBT.

6. Alfred Adler • was born to a Jewish family, second of six children, in Vienna. • had a sickly childhood. He suffered from rickets. His physician told his father: «your boy is lost.» • His father encouraged Adler.

7. Alfred Adler • obtained medical degree from University of Vienna. • married Raissa Timofeyewna Epstein, an early socialist and feminist.

8. Alfred Adler • met Freud in 1902. Adler attended “Wednesday evenings”. • He defended Freud’s “Interpretation of Dreams” and then was invited to what became the Vienna Psychoanalytic Society • was man with his own ideas before meeting Freud. • In 1911, as president of Vienna’s Psychoanalytic Society, Adler read a highly controversial paper (the masculine protest) at odds with Freudian theory. Adler emphasized the power of culture and socialization.

9. He noted that some women who reacted to this cultural situation by choosing to dress and act like men were suffering not from penis envy, but from a social-psychological condition he referred to as the masculine protest. In extreme cases, males who suffered from the masculine protest began dressing and acting like girls or women.

10. Alfred Adler After this presentation, Adler left the Vienna Psychoanalytic Society. He and his colleagues established The Society for Individual Psychology. According to Individual psychology, human functioning was not only biologically based, but also powerfully influenced by social, familial, and cultural factors. The key to psychological health and well-being was encouragement.

11. THEORETICAL PRINCIPLES The Whole Person: Adler didn’t believe in dichotomies the individual into different functional parts. He emphasized unity of thinking, feeling, acting, attitudes, values, the conscious mind, and the unconscious mind.

12. Adler avoided reductionism. Freud was reductionist. • Reductionism X Holism • Adlerian holism: Humans are a single complete unit; a whole that cannot and should not be divided into separate parts (id, ego, superego).

13. Striving with Purpose According to individual psychology, humans actively shape themselves and their environments. There is a third element—beyond biology and the environment—that influences and directs behavior; Adler referred to this third force as “attitude toward life” Attitude toward life is composed of a combination of individual human choice and purpose.

14. Striving with Purpose Human behavior is purposeful. We move toward specific goals in life. Humans are driven by hopes for the future, rather than instinctual forces from the past. Adler referred to the endpoint of our future purposeful striving as fictional finalism because the endpoint is each individual’s subjective fiction.

15. Striving with Purpose • Everyday behavior can be analyzed with respect to its purpose. When an Adlerian therapist notices a maladaptive quality to the client’s behavior patterns, threapist wonders why that behavior occurs. • For Adler, the question was neither ‘How does mind affect body?’ nor ‘How does body affect mind?’ but rather ‘How does the individual use body and mind in the pursuit of goals?”

16. Striving with Purpose • Striving with purpose is helpful in child psy and parenting. Dreikurs identified «the four goals of misbehavior» to understand of children misbehavior. • To get attention • To get power or control • To get revenge • To display inadequacy

17. Social Interest and Community Feeling Humans are born into an interpersonal context. As a consequence, the development of individual personality is shaped by interpersonal factors. When an individual experiences a deep sense of connection to others, he or she is experiencing community feeling.

18. Social Interest and Community Feeling • Social interest is community feeling in action.Social interest or a sense of social responsibility is a goal of therapy. As an individual’s social interest develops, so does the capacity for empathy. Psychologically healthy individuals feel a sense of communion with others. • Social interest is positively related to spirituality,positive psychology & attachment.

20. Striving for Superiority The most basic human motive is striving for superiority. Individuals strive for a perceived plus in themselves and their lives. Within the individual there is opportunity for both interpersonal gain and individual developmental gain. Adler is neutral. He doesn’t believe in the innate goodness or innate destructiveness of humans. He believes we are what we make ourselves; we have within us the potential for goodness and evil.

22. Striving for Superiority (cont.) Adler viewed individualistic superiority striving as a sign of psychopathology. The basic striving is the striving for completeness. Even a flower that grows strives to reach its completeness. The fundamental law of life is to overcome one’s deficiencies. Humans strive; we are active, creative, and persistent in our drive to move toward completion and excellence. We can become discouraged and resigned due to unfortunate life circumstances, but our natural state is forward moving.

24. Phenomenology Adler was an early existentialist; the concept of phenomenology is a central assumption of individual psy. Individual experience is a subjective fiction based on each individual’s perception. The individual actively creates and adapts personal reality. Adler had an influence on Victor Frankl and Rollo May.

25. An Idiographic Approach For Adler, general statements about humans and human psychology are helpful, but of limited use. A human being cannot be typified or classified. Every individual is unique. To really understand an individual, a couple,or a family, you must work with that individual, couple or family. Meeting and spending time with clients are more important than providing a diagnostic label. Individual psy is about the psy of the single, unique, whole individual.

26. Soft Determinism Individual psychology is not deterministic approach. Adler didn’t emphasize the causal determinants of human behavior. Soft determinism is the midpoint between deterministic, cause-and-effect thinking and nondeterminism which assumes no causal connections.

27. Soft Determinism From the individual psychology perspective, human behavior is a function of a combination of influences. There is no single, direct causal factor that produces a single behavior. There are many influences or contributing factors. Adler believed every individual is responsible for his/her behavior. Adlerian theory is hopeful and optimistic.

28. Lifestyle: The Early Cognitive Map Adler was deeply influenced by Hans Vaihinger. According to Vaihinger, we each create our own world and then live by the rules we’ve created. Vaihinger’s philosophy is based on a cognitive psychological model. Vaihinger’s book was “The Philosophy of «As If»” Adler referred to a client’s fictional goals or fictional finalism as a future-oriented concept that influences an individual’s present behavior. An individual’s lifestyle is both conscious and unconscious. It is a subjective cognitive map of how the world works.

29. Lifestyle: The Early Cognitive Map The future is now. This is because the future strongly influence your everyday behavior. In addition, the future is then. This means that your future was established by your early childhood experiences. Humans are characterized by continuity; the past, present, and future are all closely intertwined. An individual’s personal continuity or lifestyle may be more or less adaptive. Some people hold onto beliefs about the self, world, and others that cause them emotional pain and distress. Adler has referred to these beliefs as basic mistakes, and these cognitive mistakes are an obvious target of therapy.

30. Adler is hopeful and optimistic about the possibility for helping individuals change their cognitive maps through therapy.

31. Tasks of Life Adler believed all humans face 3 life tasks: • Work, or occupation • Love and marriage • Social Relationships Later, other Adlerians added 3 more tasks: • Self • Spirituality • Parenting and Family These six tasks constitute the challenges of life.

32. The clients come to therapy because they have had difficulty with one or more basic life tasks. The difficulties arise from mistakes and maladaptive perceptions associated with their lifestyle. The goal of therapy is to help clients adjust or modify their lifestyles in ways that help them more effectively complete their life tasks.

33. Work or Occupation This is a life demand that we all must face and work through. Adler believed the best way to solve the life task of work or occupation was by solving the second life task, social relationships, through “friendship, social feeling, and cooperation”.

34. Social Relationships Adler proposed positive social relationships. Establishing healthy social relationships was the key to solving the work or occupational problem. Humans are interdependent. Everyone needs to belong to some social group. Humans need to belong and are interdependent and must also face the life task of dealing with relationships. Some clients come to therapy because they have social relationship problems. From the Adlerian perspective, clients’ social problems arise from inappropriate expectations, beliefs, and interpersonal habits.

35. Love and Marriage Adler viewed marriage as a partnership. Many clients come to therapy with intimacy problems, both sexual and nonsexual. Road to recovery: modify the lifestyle and develop empathy (community feeling).

36. Self This task emphasizes that everyone has a relationship with himself or herself. The nature of your relationship with yourself is established during childhood. Mosak and Maniacci describe four dimensions of the self life task: • Survival of self: Am I taking good care of my physical self? Am I taking good care of my psychological self ? Am I taking good care of my social self ? • Body image: Is my perception of my body reasonable and congruent with my actual body?

37. Self • Opinion: What is my opinion of me? To evaluate this in an interview, Adlerians often ask clients to complete the incomplete sentence, “I ....me”. • Evaluation: Some clients have various extreme perspectives of the self. From the object relations perspective, the question would be “Am I good or am I bad?”

38. Spirituality Mosak and Maniacci describe five specific issues related to the spirituality task. As individuals grow up and face life, they must approach and deal with each of these issues: • Relationship to God: • Religion: • Relationship to the universe: • Metaphysical issues: • Meaning of life:

39. Parenting and Family Giving birth to, raising a child & functioning as a family are extensions of love and marriage task. Some individuals function as single parents and raise children outside marriage. Individual parents also develop strong feelings and beliefs about how children should be raised. How individuals face the parenting and family task is both a function of and a challenge to the lifestyle.

40. Parenting and Family Adlerian parenting approach has some core characteristics: • Democratic-authoritative • Autocratic/authoritarian or permissive • Responsive • Problem-solving • Encouragement • Punishment • Contemporary parenting authorities

41. Theory of Psychopathology Psychopathology is often defined as “discouragement”. The discouraged individual is unable or unwilling to approach and deal with essential life tasks. In the case of mental disorder, one or more of the life tasks have become overwhelming. The person struggling to adequately face a life task becomes discouraged. He or she feels inferior or unable to successfully manage the life task demands, and therefore symptoms arise.

42. Psychopathology and Human Change Patients are suffering from the effects of their inaccurate or mistaken lifestyles. Symptoms become an answer to the question “What shall I do if I cannot successfully manage this life task?” From an Adlerian perspective, symptoms have a purpose and help individuals avoid facing life tasks. For example “If I become anxious, I will not have to approach one or more of the basic life tasks. Perhaps I can avoid marriage or work.”

43. Although feelings of inferiority are natural, they can also become pathological.

44. The Practice of Adlerian Therapy • In the practice of Adlerian therapy, there are four phases: 1. Forming the therapeutic relationship 2. Lifestyle assessment and analysis 3. Interpretation and insight 4. Reorientation

45. The Practice of Adlerian Therapy II • Forming the therapeutic relationship • The relationship is equalitarian and characterized by listening and caring. • The therapist is like a friendly teacher or business consultant. Therapist and client sit on chairs of equal status and look more or less directly at one another. Therapy is conducted collaboratively. “What do you want me to know about you? • Clients are encouraged to be active participants in therapy.

46. The Practice of Adlerian Therapy III • Therapist-client goal alignment is important; sample goals include: • Fostering client social interest or community feeling • Helping clients overcome feelings of inferiority and discouragement. • Helping clients change the basic mistakes embedded in their lifestyle. • Shifting client motivation from self-focused superiority to a community focus. • Helping clients believe and feel as equals in their relationships. • Helping clients become contributing members to society.

47. The Practice of Adlerian Therapy IV • The therapist focuses mostly on positives and not pathology. • Focus on client strengths. • There is also sometimes a focus on client problems. Adlerians focus on the person and strengths as well as problems. The goal is to establish an environment characterized by encouragement.

48. Initial Lifestyle Interpretations “Tell yourclient something you’ve learned about him toward the end of the first session” The purpose of this early interpretation is to further the connection between therapist and client and begin the process of a deeper analysis.

49. Lifestyle Assessment and Analysis Several approaches to lifestyle assessment are available. The main assessment strategies are: • The family constellation interview • The question • Earliest recollections (memories)

50. The Family Constellation Interview is a particular approach to obtaining information about the client’s childhood experiences. Topics covered include descriptions of each family member, descriptions of how family members interacted with one another, how each family member was viewed by the client, who fought, who didn’t fight, and more. Adler considered birth order to be a strong contributor of lifestyle. He emphasized that every individual is born into a different family; this is because with the addition of a new family member, the family dynamics change and a new family is born.